Heart failure affects approximately 5 million Americans, it is the leading cause of death in the United States, and it is the single most costly health care challenge [2]. Roughly 550,000 new cases of HF occur each year [2-3]. In the U.S. in 2004, the estimated direct and indirect costs for HF are estimated to be $28.7 billion [2]. Rehabilitation efforts are aimed at improving health status and quality of life (QOL), while reducing healthcare costs and hospitalizations. The American College of Cardiology/American Heart Association evidence-based practice guidelines identified exercise as a key factor for managing HF [4]. Exercise intolerance is a fundamental symptom with HF, presenting limitations on functional status and QOL. However, implementation of rehabilitation programs for HF populations have been challenging, and adherence is a problem. A user-centered telehealth-supported home-based exercise program, with frequent feedback, may enhance adherence and improve exercise tolerance, HF symptoms, and QOL. The purpose of this prospective 2-group experimental study is to compare the effects of a 12-week tele-health home exercise rehabilitation program with usual treatment, for patients with moderate HF. Thirty-six subjects with Class II or III HF will be enrolled (18 per group). Subjects in the experimental group will be provided with an exercise prescription, a recumbent stationary bike, and tele-monitoring equipment. Daily monitoring of heart rate (HR), blood pressure (BP), oxygenation (SPO2), and weight will be conducted for those in the experimental group, in order to insure that they are safe to exercise. Regularly scheduled tele-visits will be held for experimental subjects to provide tele-coaching and tele-support. Dependent variables to be compared include the Minnesota Living with Heart Failure Questionnaire, 6-minute walk test, Specific Activity Scale, Profile of Moods States, HR, BP, SPO2, and heart rate variability. Findings from this study will provide pilot data and a refined protocol for a larger randomized clinical trial.